Шкала оценки выраженности спаечного процесса брюшной полости

Abstract

A retrospective analysis of 154 case histories of patients with adhesive disease of the abdominal cavity complicated by intestinal obstruction was carried out. The following data were taken into account in the analysis: age, sex, history of operations, availability of hospitalizations and operations for adhesions, their number, methods of treatment, intraoperative evaluation of the adhesion process, the outcome of the hospitalization. For an objective assessment of the severity of the adhesive process, we developed a scale for assessing the degree of adhesive process in the abdominal cavity, which takes into account not only the number and location of adhesions in the abdominal cavity, but also the structure of adhesions, the presence or absence of vascularization, and the presence of deformation of the intestinal tube. The degree of adhesion in the operated patients made 13 points, which corresponds to the pronounced adhesion of the abdominal cavity organs. Mortality rate was 10 %. In patients died from complications, the degree of adhesive process made 14 points. The first signs of adhesion of the abdominal organs appeared 3 years after the operation. And the number of operations for acute intestinal obstruction to the recurrence was 0.27. Spearman's correlation analysis revealed an average significant correspondence between the degree of adhesion and the outcome of treatment. A reliable correspondence between the likelihood of postoperative complications and the severity of the adhesion process was also revealed. A pronounced adhesion process in the abdominal cavity suggests a significant likelihood of repeated operations for adhesions. Thus, the proposed scale is an objective method for evaluating the adhesion process in the abdominal cavity and makes it possible to assume the probability of postoperative complications and relapse of adhesive intestinal obstruction.